1. Field of the Invention
The present invention relates to a comfortable harness device for tensioning the temporomandibular joint (TMJ) in the treatment of dislocations and fractures of the jaw.
2. Brief Description of the Prior Art
Dislocations of the jaw are most often caused by a blow to the face, but occasionally they are caused by chewing large pieces of food, yawning, or even laughing. Treatment of acute dislocations is by reduction while less severe conditions may be treated by snapping the jaw back in place with the thumbs inside of the mouth. When reduction is required, a local anesthetic is injected into the lateral pterygoid and temporalis muscles which may allow the mandible to reduce spontaneously. Alternatively, or in addition, downward pressure may be applied by the physician after the patient has been given a general anesthetic or narcotic. After the dislocation has been treated, the jaw should be temporarily stabilized with a Barton bandage or the like to maintain the mandible in a reduced position. A Barton bandage is made with an elasticized tape such as an Ace bandage that is wound about the patient's head in a double figure-of-eight.
A Barton bandage is very uncomfortable to wear. The bandage has a tendency to slip and usually requires reapplication almost daily. The pressure of the elastic band may cause headaches. It may also cause the skin to breakdown under the bandage and compressive sores to form.
Because of the problems with a Barton bandage, there have been other devices proposed for use in stabilizing the jaw, many of which include a strap that passes over the wearer's forehead or includes an elastic strap that goes under the wearer's chin. These devices are also uncomfortable and not suitable, as described below, for those patients who may need to wear the bandage for the rest of their lives.
Patients who have had a stroke or who are in a coma sometimes experience repeated dislocations of the jaw brought on by uncontrolled yawning. Under these circumstances, it is necessary to permanently place the jaws in a fixed position. A Barton bandage cannot be used for this purpose as it exerts a compressive force that may cause skin breakdown and compressive sores. Hence, the usual practice is to stitch the upper and lower jaws together, leaving some slack in the thread so that a tube may be inserted between the upper and lower teeth. Sometimes the sutures are torn loose as the patient yawns and, even when they hold, they are in the way for oral hygiene, suctioning and the like.
Fractures of the mandibular condyle are also generally caused by trauma to the chin and treatment usually involves intermaxillary fixation.